The Day I Learned That Flying Starts Long Before the Airplane Takes Off.

I used to think flying was the easy part of traveling.

Book the ticket.

Pack a suitcase.

Arrive at the airport.

Board the plane.

COPD taught me that flying actually begins weeks before departure.

One of the first things that surprised me was something most passengers never think about.

Commercial aircraft don't fly at sea level.

Although the cabin is pressurized, the air inside the aircraft contains less available oxygen than what we're used to breathing on the ground. For healthy lungs, that's usually not a problem. For someone living with significant lung disease, it can make a remarkable difference.

I discovered that the hard way.

Years before my transplant, my wife and I were driving through the Carpathian Mountains in Romania.

Eventually we reached an elevation of about 2,200 meters (7,200 feet).

The scenery was spectacular.

My lungs were less impressed.

I stepped out of the car, took a few steps...

...and stopped.

Every breath felt expensive.

My heart raced.

My chest tightened.

The view was magnificent.

I could barely enjoy it.

At the time, I didn't realize I had just experienced something very similar to what happens inside an airplane cabin.

That mountain became my first flying lesson.

From that day on, I stopped assuming that because I could breathe on the ground, I'd automatically breathe comfortably in the air.

Instead, I asked my pulmonologist.

That conversation changed the way I traveled.

Many hospitals can perform a Hypoxia Altitude Simulation Test (HAST) or another assessment to estimate whether you'll need supplemental oxygen during a flight. Not everyone with COPD or another lung disease needs in-flight oxygen, so the decision should be based on your individual condition rather than guesswork.

For me, the answer was clear.

A portable oxygen concentrator became part of my travel routine.

Oddly enough, carrying oxygen made flying less stressful.

Not more.

Once I stopped worrying about whether I'd become breathless at 35,000 feet, I could go back to thinking about the things everyone else worries about.

Passport.

Boarding pass.

Finding overhead luggage space.

The oxygen concentrator simply became another travel companion.

Much like my passport, I never left home without it.

People often ask me whether airlines make traveling with oxygen difficult.

My experience has generally been the opposite.

Most airlines have clear procedures for passengers using FAA-approved portable oxygen concentrators. The important part isn't arguing with airport staff at the gate—it's contacting the airline well in advance, confirming their requirements, checking battery rules, and making sure your specific device is approved for use onboard.

Planning is much easier than improvising.

Looking back, I think the biggest lesson had very little to do with oxygen.

Chronic illness changes the way you travel.

Not because it prevents adventure.

Because it rewards preparation.

The better I planned, the less my disease occupied my thoughts once the journey actually began.

Today, after my transplant, I no longer travel with supplemental oxygen.

Every time I board an airplane, I quietly think about that younger version of myself standing breathless on a Romanian mountaintop, wondering what had just happened.

He thought his world was getting smaller.

He had no idea how many more journeys still lay ahead